Unorthodox Treatment of Presumed Chronic Lyme Disease Can Be Deadly Interview with:

Dr. Christina Nelson, MD MPH Medical epidemiologist, Division of Vector-Borne Diseases CDC

Dr. Nelson

Dr. Christina Nelson, MD MPH
Medical epidemiologist, Division of Vector-Borne Diseases
CDC What is the background for this study?

Response: Patients who are given a diagnosis of “chronic Lyme disease” have been offered a variety of treatments that have not been shown to be effective.  Many patients are treated with prolonged courses of antibiotics (for months or years), which have not been shown to provide substantial long-term benefit to patients.  Anecdotal reports about adverse outcomes associated with these treatments for chronic Lyme disease are common, but there have not been systematic efforts to collect data about the frequency of these events. Why is the diagnosis of ‘Chronic Lyme Disease’ so common?

Response: The term “chronic Lyme disease” (CLD) has been used to describe people with different illnesses. While the term is sometimes used to describe illness in patients with Lyme disease, in many occasions it has been used to describe symptoms in people who have no evidence of a current or past infection with Lyme disease.  Because of the confusion in how the term CLD is employed, experts in this field do not support its use. What are the main findings of your report?

Response: This paper describes five patients who developed life-threatening infections as a result of unorthodox treatments for CLD.  One patient died as a result, and another patient nearly died of sepsis. This report highlights examples of serious complications associated with these treatments. What should readers take away from the cases reported in your article?

Response: Incorrect diagnosis of Lyme disease and treatment with long-term antibiotics can have devastating effects. This report underscores the importance of patients to be aware of the risks of alternative treatments so they can make informed decisions about their health care. We want people to get the right diagnosis and the appropriate care. What recommendations do you have for future research as a result of this study?

Response: Any of the following could provide additional information to help characterize these complications beyond the case series mechanism used in this MMWR: clinician surveys, analyses of administrative claims databases, or implementation of state or local reporting systems for adverse outcomes related to these treatments. Systematic investigation of these complications would be helpful to inform clinical practice and fully characterize the risks associated with treatments for chronic Lyme disease. Is there anything else you would like to add?

Response: The purpose of the MMWR case series was to help document these cases in the medical literature in order to illustrate the risks of these treatments.  As is customary for case reports/case series published in peer-reviewed scientific literature, the goal was to highlight an important medical or public health finding.  It’s important to understand that the cases described were selected examples of serious adverse outcomes.  Therefore they do not necessarily represent a specific proportion of patients who have had adverse outcomes from treatments for chronic Lyme disease.

No disclosures Thank you for your contribution to the community.


Marzec NS, Nelson C, Waldron PR, et al. Serious Bacterial Infections Acquired During Treatment of Patients Given a Diagnosis of Chronic Lyme Disease — United States. MMWR Morb Mortal Wkly Rep 2017;66:607–609.


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